Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Richard A. P. Takx; Rozemarijn Vliegenthart; F.A.A. Mohamed Hoesein; I Isgum; Harry J. de Koning; WPTM Mali; Carlijn M. van der Aalst; P Zanen; Jan-Willem J. Lammers; Harry J. M. Groen; Eva M. van Rikxoort; Michael Schmidt; Bram van Ginneken; Matthijs Oudkerk; Tim Leiner; Pim A. de Jong

doi:10.1007/s00330-014-3384-6

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Richard A. P. Takx^*, Rozemarijn Vliegenthart, F.A.A. Mohamed Hoesein, I Isgum, Harry J. de Koning, WPTM Mali, Carlijn M. van der Aalst, P Zanen, Jan-Willem J. Lammers, Harry J. M. Groen, Eva M. van Rikxoort, Michael Schmidt, Bram van Ginneken, Matthijs Oudkerk, Tim Leiner, Pim A. de Jong

^*Corresponding author for this work

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Abstract

Objective The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events.

Methods In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1% predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices.

Results 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV1% predicted, 1.000 (95% CI 0.986-1.015) for FEV1/FVC, 1.014 (95% CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95% CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (

Conclusions Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events.

Original language	English
Pages (from-to)	65-71
Number of pages	7
Journal	European Radiology
Volume	25
Issue number	1
DOIs	https://doi.org/10.1007/s00330-014-3384-6
Publication status	Published - Jan 2015

Keywords

Cardiovascular diseases
Spirometry
Multi-detector computed tomography
Smoking
Mass screening
CORONARY-ARTERY CALCIUM
COMPUTED-TOMOGRAPHY SCANS
HEART-DISEASE
SYSTEMIC INFLAMMATION
FUNCTION IMPAIRMENT
MORTALITY
EMPHYSEMA
PREDICTION
SMOKING
DECLINE

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Takx, R. A. P., Vliegenthart, R., Mohamed Hoesein, F. A. A., Isgum, I., de Koning, H. J., Mali, WPTM., van der Aalst, C. M., Zanen, P., Lammers, J.-W. J., Groen, H. J. M., van Rikxoort, E. M., Schmidt, M., van Ginneken, B., Oudkerk, M., Leiner, T., & de Jong, P. A. (2015). Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study. European Radiology, 25(1), 65-71. https://doi.org/10.1007/s00330-014-3384-6

@article{d78554582daa4a7993df35f849d0adba,

title = "Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study",

abstract = "Objective The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events.Methods In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1% predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices.Results 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV1% predicted, 1.000 (95% CI 0.986-1.015) for FEV1/FVC, 1.014 (95% CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95% CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (Conclusions Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events.",

keywords = "Cardiovascular diseases, Spirometry, Multi-detector computed tomography, Smoking, Mass screening, CORONARY-ARTERY CALCIUM, COMPUTED-TOMOGRAPHY SCANS, HEART-DISEASE, SYSTEMIC INFLAMMATION, FUNCTION IMPAIRMENT, MORTALITY, EMPHYSEMA, PREDICTION, SMOKING, DECLINE",

author = "Takx, {Richard A. P.} and Rozemarijn Vliegenthart and {Mohamed Hoesein}, F.A.A. and I Isgum and {de Koning}, {Harry J.} and WPTM Mali and {van der Aalst}, {Carlijn M.} and P Zanen and Lammers, {Jan-Willem J.} and Groen, {Harry J. M.} and {van Rikxoort}, {Eva M.} and Michael Schmidt and {van Ginneken}, Bram and Matthijs Oudkerk and Tim Leiner and {de Jong}, {Pim A.}",

year = "2015",

month = jan,

doi = "10.1007/s00330-014-3384-6",

language = "English",

volume = "25",

pages = "65--71",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer-Verlag",

number = "1",

}

Takx, RAP, Vliegenthart, R, Mohamed Hoesein, FAA, Isgum, I, de Koning, HJ, Mali, WPTM, van der Aalst, CM, Zanen, P, Lammers, J-WJ, Groen, HJM, van Rikxoort, EM, Schmidt, M, van Ginneken, B, Oudkerk, M, Leiner, T & de Jong, PA 2015, 'Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study', European Radiology, vol. 25, no. 1, pp. 65-71. https://doi.org/10.1007/s00330-014-3384-6

TY - JOUR

T1 - Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants

T2 - the NELSON study

AU - Takx, Richard A. P.

AU - Vliegenthart, Rozemarijn

AU - Mohamed Hoesein, F.A.A.

AU - Isgum, I

AU - de Koning, Harry J.

AU - Mali, WPTM

AU - van der Aalst, Carlijn M.

AU - Zanen, P

AU - Lammers, Jan-Willem J.

AU - Groen, Harry J. M.

AU - van Rikxoort, Eva M.

AU - Schmidt, Michael

AU - van Ginneken, Bram

AU - Oudkerk, Matthijs

AU - Leiner, Tim

AU - de Jong, Pim A.

PY - 2015/1

Y1 - 2015/1

N2 - Objective The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events.Methods In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1% predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices.Results 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV1% predicted, 1.000 (95% CI 0.986-1.015) for FEV1/FVC, 1.014 (95% CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95% CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (Conclusions Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events.

AB - Objective The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events.Methods In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1% predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices.Results 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV1% predicted, 1.000 (95% CI 0.986-1.015) for FEV1/FVC, 1.014 (95% CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95% CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (Conclusions Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events.

KW - Cardiovascular diseases

KW - Spirometry

KW - Multi-detector computed tomography

KW - Smoking

KW - Mass screening

KW - CORONARY-ARTERY CALCIUM

KW - COMPUTED-TOMOGRAPHY SCANS

KW - HEART-DISEASE

KW - SYSTEMIC INFLAMMATION

KW - FUNCTION IMPAIRMENT

KW - MORTALITY

KW - EMPHYSEMA

KW - PREDICTION

KW - SMOKING

KW - DECLINE

U2 - 10.1007/s00330-014-3384-6

DO - 10.1007/s00330-014-3384-6

M3 - Article

SN - 0938-7994

VL - 25

SP - 65

EP - 71

JO - European Radiology

JF - European Radiology

IS - 1

ER -

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Abstract

Keywords

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